Any Cryptococcus Survivors or Success stories?

suzieeq

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I'm feeling so discouraged lately. And was hoping to hear of anyone who's had some success with fighting Cryptococcus, or just success stories in general.

I adopted my cat Merlin a year ago. He was found in the parking lot of Target and came with giardia. I successfully treated him for that. In March of this year, he started showing symptoms of a upper respiratory infection (sneezing and runny eyes). I took him to 3 different vets that month and they all kept diagnosing him with an upper respiratory infection and kept giving him different antibiotics. He didn't get better so I took him in to the vet again and this time, they did blood work, PCR test and took xrays. He came back positive for this bacteria called mycroplasma. He then went on another set of antibiotics. However, he started getting a swelling on his nose bridge and I noticed he had really enlarged lymph nodes so back to the vet I went. The vet told me enlarged lymph nodes was not common for cats. He suspected cancer or a fungal infection. He did a cytology on the lymph nodes and it came back positive for cryptococcus, a fungal infection. He titer level was 1: 32768 (I'm not even sure what that means but the vet said thats really high)

I was told it takes months, maybe even years to get rid of this fungal infection :( My vet told me that most pet owners end up putting their cat down... not because its not treatable but because the treatment is so long and expensive. Merlin is only a year and half old, so of course I wanted to fight it regardless of price. We started the cryptococcus treatment on May 13 (He is on 4 ml of Itrafungol itraconazole and .5 ml of prednisolone daily). 2 weeks into the medicine, it started cause diaherra which caused him to not eat so then he also went on metroznole to help with his stool.

It is sooo hard to give him his medication. He is normally the sweetest cat but fights me tooth and nail with liquid medication. I have scratches all over my body and I get so stressed out when it comes time to give him his medication. I'm sure he can feel I'm stressed out which is probably stressing him out as well. The prednisolone medicine makes him gag every single time I give it to him and then he ends up throwing up every so often right after I give it to him.

It's now been a month on the medication and I don't see any visible signs of improvement. The swelling on his one nostril is so bad that he can't breathe out of it at all. I dont know if its the medicine or his swollen lymph nodes or maybe just the fact that he can't smell his food, but he only eats about half his normal portion of food. I have an appointment with an internal medicine specialist in two weeks. And another appointment with my regular vet in three weeks to check his titer levels and to check his kidney to make sure his kidneys are okay on all this medicine. I feel so bad for him and I feel so helpless :(
 

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silent meowlook

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I am sorry about your cat. That nose is a classic sign of Cryptococcus. Has your cat been checked for FELV/FIV?
Cryptococcus is a yeast like fungus. It is difficult to fully eradicate but I have seen cats treated successfully for it. I think the appointment with the specialist is a really good idea.

Hopefully your cat is indoor only. If not, he really should be.

Can you get the medications in a pill or capsule form? I know they make the fluconazole in capsules. I would try using that instead of a liquid. There is also a medication called Amphoteracin B that is is given in a large amount of fluids. We would use that for the difficult cased. I think you should mention it to the specialist.

I have never heard of using prednisolone with crypto, so also ask the specialist about that as well.

I would say that most cases have a favorable outcome provided the owner can commit to the treatment which can be for months.

I think you will have more answers when you speak to the specialist. Hang in there.
 

MissClouseau

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Merlin looks gorgeous even with his health issues.

I don’t have much to offer on this type of infection but for the pill part, have you tried something like Pill Pockets?

You may see a suggestion you haven’t tried yet maybe...

Pilling Cats: Must-know Tips For Hiding Pills – TheCatSite Articles

How Can I Give A Pill To My Cat – TheCatSite Articles

Getting Cat To Take Pills... Post Tips Here.

I’m told by a vet skin problems including a fungal infection should involve skin-focused supplements and supporting the general immune system.
 
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suzieeq

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S silent meowlook Yes he has been checked for FELV/FIV twice. Once last year when I first adopted him and then again when this started. And yes, he is indoor only. He has never escaped either so I have no clue how he even got this as I heard its from pigeon droppings. My vets theory is that he already had it from living on the streets and when his immune system was down from the mycroplasma, it caused the cryptococcus to flare up. My regular vet's has only come across this cryptococcus a handful of times he said and mostly dogs so its kind of a learning process for him as well. He was the one that recommended me to the internal medicine specialist who actually turned out to be my high school friend. I messaged her before making the appointment, and she told me the same thing as you. She said they use AmpB 3 times a week for those who don't respond to treatment. I googled it and it says its given thru an IV over a period of time so I'm really hoping it doesn't come down to that as I don't even know how to I would get him to the vet 3 times a week with my work schedule. I'm going to ask more questions and hopefully get more details when I have my appointment with her. I did a search for cryptococcus on this site and saw alot of message threads where the outcome was not favorable but I noticed their cats had cryptococcus where it had reached the central nervous system already. I don't think it has reached Merlin's central nervous system yet, so fingers crossed.

I did ask my vet for pills as I'm a pro at pills. But he said the intrafungol doesn't come in pill form. I did read about fluconazole being use as a treatment.. I'm not sure why my vet started out with intrafungol. But I will ask the specialist about using flucanazole, as well as the prednisolone. My vet told me the prednisolone is for the inflammation. Merlin actually threw up a little blood after taking his dose of prednisolone yesterday so I'm waiting for my vet's call back regarding that. Maybe he will lower the prednisolone dosage.

MissClouseau MissClouseau Aww thank you. I think he is beautiful too, but I am pretty biased :) I actually have tried pill pockets ... but my cats hate the taste of them. Unfortunately his current medication is liquid :( And alot of liquid! 4 ml, I have to give it to him slowly and a little bit at a time so he doesn't choke on it or throw up. It's very traumatizing for both him and me lol. I've started wrapping my arm in those thick fabric bandages before giving him medicine to save my arm from being scratched up so much.
 
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suzieeq

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I was also wondering if anyone knows whether or not the damage to his nose is reversible. I asked my vet and he said they can't surgically remove that swelling nodule in his nose or whatever it is. I'm not really sure if the fungal medicine is supposed to make that go away or if he will have this nose swelling forever now.
 

fionasmom

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I am so sorry that you are facing this. Several years ago I rescued an adult male cat from the streets....actually, he came up to my front door because he saw that I had a TNRed cat who ate at my house and cried for me to come out and give him food. He was the sweetest little boy, all white, Pangur Ban. When I decided, shortly after, to bring him in I simply picked him up and put him in a carrier and brought him to the vet to be fixed. I did not even need a trap.

A few months later, out of nowhere, he had a massive seizure. Nothing like hyperesthesia but a full blown thrashing gasping seizure. We run to the ER and after a few tests, along with a trip to my cat vet, we began to suspect cryptococcus which it was. Within a couple of weeks he was entirely blind followed by what appeared to be more CNS involvement. I let him go shortly after that as he had no quality of life.

From what I was told about cryptococcus, it does come from pigeons and a fungus in the soil. Certainly enough of them around here and he had been on the street for a while. It is systemic, so can go various places once it has a foothold. For Pangur, aside from a few sneezes about which I would have had to be psychic to know that they might have been the first sign, it moved directly to the CNS. However, in the case of Merlin, you have been able to start to fight it and that is what you should continue to do. He does have a chance since he is under treatment and the first signs were caught.

I was told by my vet that the treatment for cryptococcus is a long haul, after Pangur had passed and we were discussing what had happened. Additionally, while she is a great cat vet and very knowledgeable, I did get the feeling that she just did not see that much of this disease so I am glad to read that you are taking Merlin to a specialist. I have done that since with other pets and it has always been worth it.

Will he take liquid meds with tuna water or in a very smelly cat food? I agree that if anything is made in capsule form, he should be given that. Hopefully the specialist might have more insight in other sources or formulations of the meds.

Keep fighting this with Merlin. He knows that you are trying to help him. He is a beautiful boy with his silver gray face.
 

silent meowlook

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When I worked for the Veterinary Specialist
(9 years) we saw it quite a bit. I can’t recall numbers. We would start treatment and they would be referred back to their regular Veterinary hospital, so I don’t know if the noses returned to normal. I don’t remember us ever doing surgery on one. I work for a feline only veterinarian now (x5years) and I’ve seen 4 cases. One in a 20 year old cat. The cases I have seen did resolve, but it takes a while. When I worked for the specialist I cared for a cat with no nasal swelling but severe cans signs. I took care of him for 2 weeks while the owners were out of town. I used my vacation time as caring for that cat was a 24/7 job. He was comatose in the beginning. I had to tube feed him and give meds and bring him to the hospital 3 times a week for amphoteracin b injections. He was only 2 years old and a Siamese. By the end of his stay with me he could walk, although unsteady. He could eat on his own. But the maintenance was high for him. I could tell his owners were overwhelmed when I took him home to them. They euthanized him the next day. They did call me first and I begged them to let me have him and I would continue his care and if they still didn’t want him I would keep him. I couldn’t make them understand that it wasn’t a burden to me and the euthanized him. That was the last time I did anything like that. I was heartbroken.

Sorry, not really related since his had passed the blood brain barrier. It is a nasty disease however you look at it and it does take a lot of commitment.
 
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suzieeq

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fionasmom fionasmom I am also sorry for what you went thru :( and thank you for sharing your story with me. In the beginning when he came out positive for crypto, it was so hard to find anyone who gone through this horrible infection/disease. I literally spent hours and days on the internet trying to find others who had written about their experience with it. I am so glad to have re-found this site. When a cat has a seizure, it is very obvious? I've never seen a cat or even a human have a seizure so I hope I recognize that its happening if it happens. Yes, my vet said we caught it early... but to me, it feels like I caught it late. 2 months of thinking it was just a URI. I guess it's not that common or maybe some vets don't know much about it. One of the urgent vets I had visited actually saw the swollen lymph nodes and he was the one that pointed out Merlin's nose was swollen (it was just the beginning of the nose swelling symptom so I didn't even notice it. I had taken him in because I felt his swollen lymph hones) and even he did not suspect or did not bring up cryptococcus.

S silent meowlook Oh my goodness, that is so sad. I can't imagine how heartbroken you were that they put him down after all your efforts :( I guess it is alot of work for most pet owners to fight this disease, not to mention costly. Geez, the medicine alone that only lasts 13 days is $85 each time. Luckily I have pet insurance so they cover alot of it. To be perfectly honest, if Merlin was an senior cat, I might have thought about about putting him down (I hope I dont get hate for saying that). But with his age, I just can't even think of that option. He is still so full of life. He does have a few bad days where he just stays in his cat cave but for the most part, he still plays, play wrestles with his brother, and brings me his ball to throw.

It's so weird. I read on the internet, all these websites saying to cut out the thing in the nose to help them along but when I asked my vet, he said he didn't think that was possible and that he personally had never heard of that being done. I even asked the specialist and she said the same, that it couldn't be done.

I thank you both for sharing your stories. I feel a little better just venting it out to people who understand what I'm going through.
 

hexiesfriend

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I'm feeling so discouraged lately. And was hoping to hear of anyone who's had some success with fighting Cryptococcus, or just success stories in general.

I adopted my cat Merlin a year ago. He was found in the parking lot of Target and came with giardia. I successfully treated him for that. In March of this year, he started showing symptoms of a upper respiratory infection (sneezing and runny eyes). I took him to 3 different vets that month and they all kept diagnosing him with an upper respiratory infection and kept giving him different antibiotics. He didn't get better so I took him in to the vet again and this time, they did blood work, PCR test and took xrays. He came back positive for this bacteria called mycroplasma. He then went on another set of antibiotics. However, he started getting a swelling on his nose bridge and I noticed he had really enlarged lymph nodes so back to the vet I went. The vet told me enlarged lymph nodes was not common for cats. He suspected cancer or a fungal infection. He did a cytology on the lymph nodes and it came back positive for cryptococcus, a fungal infection. He titer level was 1: 32768 (I'm not even sure what that means but the vet said thats really high)

I was told it takes months, maybe even years to get rid of this fungal infection :( My vet told me that most pet owners end up putting their cat down... not because its not treatable but because the treatment is so long and expensive. Merlin is only a year and half old, so of course I wanted to fight it regardless of price. We started the cryptococcus treatment on May 13 (He is on 4 ml of Itrafungol itraconazole and .5 ml of prednisolone daily). 2 weeks into the medicine, it started cause diaherra which caused him to not eat so then he also went on metroznole to help with his stool.

It is sooo hard to give him his medication. He is normally the sweetest cat but fights me tooth and nail with liquid medication. I have scratches all over my body and I get so stressed out when it comes time to give him his medication. I'm sure he can feel I'm stressed out which is probably stressing him out as well. The prednisolone medicine makes him gag every single time I give it to him and then he ends up throwing up every so often right after I give it to him.

It's now been a month on the medication and I don't see any visible signs of improvement. The swelling on his one nostril is so bad that he can't breathe out of it at all. I dont know if its the medicine or his swollen lymph nodes or maybe just the fact that he can't smell his food, but he only eats about half his normal portion of food. I have an appointment with an internal medicine specialist in two weeks. And another appointment with my regular vet in three weeks to check his titer levels and to check his kidney to make sure his kidneys are okay on all this medicine. I feel so bad for him and I feel so helpless :(
My cat was on fluconazole for this problem in her nasal cavity and saw results in a week. I’m not sure of the difference with what you were given. The standard treatment is 2 months continued treatment after symptoms go away. This is the standard treatment for Crypto. After a year the crypto did come back on my kitty under the skin. I took my cat to the dermatologist and she indicated that this sometimes happens when the fluconozole is discontinued too early. This time they took a blood sample to do a titer this time, a repeat blood test will be done to make sure there is no fungus in the blood before it’s pulled this time. I’ve again seen results in a week. This is entirely treatable I’m just not sure if you are on the right anti fungal.
 

fionasmom

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S silent meowlook that is one heartbreaking story that they would not let you have him when they were going to euthanize regardless. You certainly have a reward waiting for you someplace, or some good karma, for having done that.

suzieeq suzieeq Seizures and Epilepsy in Cats This includes a general description of what a seizure might look like in a cat. Pangur's was huge; I am not that experienced in seizures and I immediately knew what it was. He sort of sat up on his back legs, put his front paws up, keeled over backwards, and thrashed around on the floor. It looked like grand mal and lasted about 2 minutes. I grabbed corn syrup thinking that if this were some diabetic response, although he was not diabetic, it would help.

Signs of seizures can be subtle however, but let's be positive about Merlin and hope that he does not have any.

Paying for veterinary care is a huge concern today as human medicine has entered the realm of animal care. My three youngest cats have pet insurance, one fortunately as he has two serious conditions at 4 years old, and it is nice to get reimbursed for the $500 ultrasound. I can completely understand having to make a judicious financial decision in the face of huge costs. My cats have pet insurance because my dog easily hit 5 figures with our melanoma experience, although I am happy to say that he is alive still.

As I said yesterday, when you see a cat sneeze or have a URI, no one immediately goes to cryptococcus, so in the scheme of things you did catch this very early. As for the surgery for the nose, I am unfamiliar with that. Does not mean it does not exist, but I have not heard of it. If specialists are telling you that they have never heard of it, I would proceed with caution.

Please feel free to vent any time you need to talk.
 

daftcat75

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I don't have any experience with cryptococcus specifically. But I have plenty of experience with giving medicine on a daily/ongoing basis.

My recommendation is to get the meds compounded to more appealing (flavored liquids or treats) or easier to give forms (transdermal.) Also, keep in mind that he only has two ears and you're recommended to switch ears on transdermal meds so you can dose one ear and wipe off the prior day's dose in the other ear. 4 ml of liquid medicine is a lot to give to a cat! I would see if you can get that concentrated into a flavored oil. My Krista's chemotherapy dose would have come out to 1 mL at standard concentration. I knew I would never get her to eat 1 mL no matter the flavor. I had it concentrated 10 times so that I only had to give 0.1 mL. It was anchovy flavored. I mixed it with a touch of salmon oil and she would clean that puddle without any objection. Her pred I had compounded into a transdermal gel.

Wedgewood is my preferred compounder. They have excellent customer service. Your vet will still need to call or fax in the prescription. But you can choose the formulation. I have spoken with their pharmacists on a number of occasions to help choose a formulation or for other questions about the medication. Krista had a reaction to one of the formulations. We're not certain if it was the flavor or one of the other ingredients in the formulation (she did have IBD/GI lymphoma and was sensitive to a LOT of ingredients.) But Wedgewood went above and beyond and rushed me a different formulation at no charge.
Veterinary Pharmacy

For antibiotic-related diarrhea, search Google or this site for saccharomyces boulardii. While antibiotics will kill good bacteria with the bad, s. boulardii is yeast-based probiotic that will not be affected by the antibiotic.

More on s. boulardii:
My Cat Has Diarrhea - What Do I Do?

And the gold standard for s. boulardii is the Jarrow brand with the MOS prebiotic.
https://www.amazon.com/dp/B07NW49TC7/?tag=thecatsite

Here's another retailer if you have a Vitamin Shoppe near you:
Vitamin Shoppe
 
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suzieeq

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hexiesfriend hexiesfriend Thank you sooo much for sharing! Wow only a week before seeing results.. that is amazing!!! I'm so glad to finally hear of someone who said they were able to get rid of it in the nasal cavity area. Was your cat's nose swollen as well? My vet also said something similar, that we need to keep doing treatment for at least 2 months after titers test return back negative. We are testing his titer levels as well as doing blood work every 6 weeks. Its only been a month since we started treatment so we've only done the titer test once so far and it was 32,768. So we have quite awhile before we are even close to a negative titter. I am definitely going to ask about the fluconazole medicine on my next visit. I know that fluconazole and Intrafungol (itraconazole) are the preferred methods for Cryptococcus but I don't know what makes the vet decide on one over the other when prescribing.

fionasmom fionasmom Yes thank heavens for pet insurance. I have pet insurance on both my cats as well where I get reimbursed 80% of costs. I learned from having two prior cats. One had heart disease and thyroid problem and was on daily medication for the last 4 years of his life. And once they became senior, every visit was just soooo costly, that I enrolled my current cats in pet insurance the day I brought them home. Thank you for the link on seizures.

daftcat75 daftcat75 OH MY GOODNESS! I can't believe I have never heard of compounding medicine That is absolutely brilliant! I do not know why the pet medicine is always cherry flavored! My intrafungol is cherry caramel flavored and my predisolone is cherry flavored also. What kind of cat likes cherry flavored anything? Even if I can get it compounded to 1 ml, I would so happy. 1 ml I can deal with but 4 ml is killing me. As soon as I saw your message, I went to their website and chatted with an agent from Wedgewood but I may call to double check. The agent said they can't compound my medicine Intrafungol because its over the counter and they do not compound over the counter medicine. But its definitely not an over the counter medicine so I think she may be mistaken.
 

hexiesfriend

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Suzieeq, my cat had hers in the back of her nasal cavity near her throat so it threatened her life it not treated. I noticed that she was snorting when she ate and purred and was starting to snore when breathing. You may want to ask the vet if it’s been a month of treatment that’s too long to see no improvement. My cats snorting stopped a week after treatment, and her skin lesion a week too. the medicating is a pain I have to chase my cat around the house and wait for her to emerge from hiding. I was able to get it compounded with extra tuna flavor and it’s only 1ml 2x a day
 

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You never know. We had a cat who was mad for cherry flavor. She got some cherry flavored throat medicine when she was hoarse. After that she'd pretend to be hoarse from time to time to get it.
 
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